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Did prescribing laws disproportionately affect opioid dispensing to Black patients?
dc.contributor.authorTownsend, Tarlise N.
dc.contributor.authorBohnert, Amy S. B.
dc.contributor.authorLagisetty, Pooja
dc.contributor.authorHaffajee, Rebecca L.
dc.date.accessioned2022-06-01T20:29:52Z
dc.date.available2023-07-01 16:29:50en
dc.date.available2022-06-01T20:29:52Z
dc.date.issued2022-06
dc.identifier.citationTownsend, Tarlise N.; Bohnert, Amy S. B.; Lagisetty, Pooja; Haffajee, Rebecca L. (2022). "Did prescribing laws disproportionately affect opioid dispensing to Black patients?." Health Services Research 57(3): 482-496.
dc.identifier.issn0017-9124
dc.identifier.issn1475-6773
dc.identifier.urihttps://hdl.handle.net/2027.42/172828
dc.description.abstractObjectiveTo evaluate whether pain management clinic laws and prescription drug monitoring program (PDMP) prescriber check mandates, two state opioid policies with relatively rapid adoption across states, reduced opioid dispensing more or less in Black versus White patients.Data SourcesPharmacy claims data, US sample of commercially insured adults, 2007–2018.Study DesignStratifying by race, we used generalized estimating equations with an event-study specification to estimate time-varying effects of each policy on opioid dispensing, comparing to the four pre-policy quarters and states without the policy. Outcomes included high-dosage opioids, overlapping opioid prescriptions, concurrent opioid/benzodiazepines, opioids from >3 prescribers, opioids from >3 pharmacies.Data Extraction MethodsWe identified all prescription opioid dispensing to Black and White adults aged 18–64 without a palliative care or cancer diagnosis code.Principal FindingsExactly 7,096,592 White and 1,167,310 Black individuals met inclusion criteria. Pain management clinic laws were associated with reductions in two outcomes; their association with high-dosage receipt was larger among White patients. In contrast, reductions due to PDMP mandates appeared limited to, or larger in, Black patients compared with White patients in four of five outcomes. For example, PDMP mandates reduced high-dosage receipt in Black patients by 0.7 percentage points (95% CI: 0.36–1.08 ppt.) over 4 years: an 8.4% decrease from baseline; there was no apparent effect in White patients. Similarly, while there was limited evidence that mandates reduced overlapping opioid receipt in White patients, they appeared to reduce overlapping opioid receipt in Black patients by 1.3 ppt. (95% CI: −1.66–−1.01 ppt.) across post-policy years—a 14.4% decrease from baseline.ConclusionsPDMP prescriber check mandates but not pain management clinic laws appeared to reduce opioid dispensing more in Black patients than White patients. Future research should discern the mechanisms underlying these disparities and their consequences for pain management.
dc.publisherWiley Periodicals, Inc.
dc.publisherBlackwell Publishing Ltd
dc.subject.otherprescriptions
dc.subject.otherracial discrimination
dc.subject.otherracial disparities
dc.subject.otheropioids
dc.subject.otherpolicy
dc.subject.otherracial inequity
dc.titleDid prescribing laws disproportionately affect opioid dispensing to Black patients?
dc.typeArticle
dc.rights.robotsIndexNoFollow
dc.subject.hlbsecondlevelPublic Health
dc.subject.hlbtoplevelHealth Sciences
dc.description.peerreviewedPeer Reviewed
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/172828/1/hesr13968_am.pdf
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/172828/2/hesr13968.pdf
dc.identifier.doi10.1111/1475-6773.13968
dc.identifier.sourceHealth Services Research
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dc.working.doiNOen
dc.owningcollnameInterdisciplinary and Peer-Reviewed


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